Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body.
What does diabetes do to the kidneys?
With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.
Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.
What are the early signs of kidney disease in patients with diabetes?
The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in your doctor’s office show evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.
What are the late signs of kidney disease in patients with diabetes?
As your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.
How long does it take for kidneys to become affected?
Almost all patients with Type I diabetes develop some evidence of functional change in the kidneys within two to five years of the diagnosis. About 30 to 40 percent progress to more serious kidney disease, usually within about 10 to 30 years. The course of Type II (adult-onset or non-insulin-dependent) diabetes is less well defined, but it is believed to follow a similar course, except that it occurs at an older age.
What can I do to prevent kidney disease?
There is evidence that careful control of glucose (sugar) helps to prevent kidney disease in people with diabetes. You should follow your doctor’s orders carefully regarding diet and-medicines to help control your glucose levels.
If my kidneys are already affected, can I keep them from getting worse?
It may be possible to prevent or delay the progression of kidney disease. Since high blood pressure is one of the major factors that predict which diabetics will develop serious kidney disease, it is important to take your high blood pressure pills faithfully if you do have high blood pressure. Your doctor may also recommend that you follow a low-protein diet, which reduces the amount of work your kidneys have to do. You should also continue to follow your diabetic diet and to take all your prescribed medicines.
Are there any new treatments that can help me?
Yes. Some studies suggest that a group of high blood pressure medicines may help to prevent or delay the progression of diabetic kidney disease. These drugs reduce blood pressure in your body, and they may lower the pressure within the kidney’s filtering apparatus (the glomerulus). They also seem to have beneficial effects that are unrelated to changes in blood pressure. Patients who take these medicines may have less protein in their urine. You may want to speak to your doctor to see if these medicines could help you.
How many people with diabetic kidney disease develop total kidney failure?
About 30 percent of the people with Type I diabetes and about 10 to 40 percent of the people with Type II diabetes will eventually develop end-stage kidney failure, requiring treatment to maintain life.
If my kidneys do fail, what can I do?
If your kidneys fail, you can receive dialysis treatments or you may be a candidate for a kidney transplant. Two types of dialysis are available – hemodialysis and peritoneal dialysis. Your doctor will discuss these treatment options with you. The decision about which treatment is best for you will be based on your medical condition, your lifestyle and your personal preference.